1. Field of the Invention
This invention relates to a model and simulator for practicing ophthalmologic surgical techniques, including cataract surgery, and an apparatus for simulating the human eye structure, namely the human anterior lens capsule, to practice certain ophthalmologic surgery techniques.
2. Description of Related Art
Cataract surgery has evolved over the years as a result of contributions from many notable physicians as well as technological advances, which have led to the elegant procedure which is now commonly referred to as phacoemulsification or quite simply “phaco”. Like a carefully choreographed dance within the eye, the many intricate steps to replace the crystalline lens must happen in a precise and orderly fashion. Each step in the process, while important in its own function, is vital for the success of the subsequent maneuvers and as such assumes a greater role towards the completion of an uncomplicated procedure. A complication during the early steps of surgery can lead the surgeon to stray off course, and a cascade of events may follow which could ultimately result in a sub-optimal result.
Microsurgery in the form of phacoemulsification has a very steep learning curve which requires hands-on training. It is not possible to learn and become proficient with the techniques from reading text, watching film or even observing in the operating room. A true appreciation for the complexity of the techniques and their potential complications can only be gained through actual surgical experience. To a degree, models simulating anatomy and surgical procedures have also proved quite valuable. Various teaching tools have been developed most notably using pig eyes for practice in a laboratory setting. While these models do provide valuable experience, there are difficulties associated with procurement and disposal of the eyes. In addition, a cadaveric pig eye does not resemble the in-vivo human anatomy as closely as many would like. This is especially true in regards to the anterior lens capsule where ophthalmology residents often attempt their first capsulotomy procedure.
Arguably one of the most difficult steps of phacoemulsification to master is the creation of the continuous curvilinear capsulorhexis or “CCC” as pioneered by Howard Gimbel, MD, MPH, FRCSC. In this continuous curvilinear capsulorhexis surgical technique, the surgeon creates a small incision with a cystotome (a bent needle type surgical tool) in the center of the anterior lens capsule to form a flap. Grasping this flap of tissue, the surgeon makes a tear in a circular or curvilinear fashion.
However, this is a difficult procedure to master, and if the surgeon does not reposition and re-grasp the flap of tissue appropriately and continue to tear in the desired circular fashion, there runs the risk of creating an unwanted radial or downhill tear.
In addition, during surgery, there is the possibility of wound distortion and loss of viscoelastic material, which would in turn cause the surgical area to change from a relatively flat surface to a rounded configuration. This rounded configuration can further increase the possibility of developing an unwanted radial tear of the anterior lens capsule during this procedure.
Occurring prior to the use of the phacoemulsification probe within the eye, the successful creation of a “CCC” is vital to the safety of the procedure and the long-term stability of the lens implant within the eye. This invention presents a new teaching tool to help ophthalmology residents understand and practice the technique of creating a continuous curvilinear capsulorhexis. The inventors and eye surgeons (specifically Dr. Alexander Hatsis, Dr. Carlos Montoya, Jr. and Dr. Stuart Stoll) have collaborated to create this surgical teaching tool, which has now been endorsed by Dr. Howard Gimbel. This invaluable surgical teaching and practicing tool is easily accessible, portable, lightweight, and accurately mimics the physical feel and touch of human eye anatomy. While it seems that Dr. Charles Kelman, M.D. the father of modern-day cataract surgery, was right when he said that not every ophthalmologist is qualified to perform phacoemulsification, this teaching aid should help in part to flatten the learning curve and provide realistic hands-on experience.
From the preceding descriptions, it is apparent that the devices currently being used have significant disadvantages. Thus, important aspects of the technology used in the field of invention remain amenable to useful refinement.